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General NPI Number Information
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NPI Number | 1588216311
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Entity Type | Organization
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Legal Business Name | ASA PHARMACY LLC
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Dates
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Enumeration Date | 07/11/2019
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Last Update Date | 04/23/2022
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Provider Practice Location Address
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Address Line | 419 N LA SALLE ST
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City | NAVASOTA
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State | TX
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Zip | 77868-2435
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Country | US
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Telephone | 936-825-3470
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Fax | 936-825-3472
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Provider Business Mailing Address
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Address Line | 419 N LA SALLE ST
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City | NAVASOTA
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State | TX
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Zip | 77868-2435
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Country | US
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Telephone | 936-825-3470
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Fax |
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Authorized Official
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Title or Position | OWNER/ PHARMACIST IN CHARGE
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Name | AHMAD ALALA
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Credential | RPH
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Telephone | 936-825-3470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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